Translational psychiatry
November 8, 2021
Manoj K Doss, Michal Považan, Monica D Rosenberg et al.
343 citations
Psilocybin therapy increased cognitive flexibility for at least four weeks in 24 patients with major depressive disorder, though these improvements were not linked to antidepressant effects. One week after treatment, glutamate and N-acetylaspartate concentrations decreased in the anterior cingulate cortex (ACC), and functional connectivity dynamics increased between the ACC and posterior cingulate cortex. Surprisingly, larger increases in this neural flexibility were associated with smaller gains in cognitive flexibility. Baseline brain connectivity from the ACC predicted cognitive flexibility improvements, with greater baseline connectivity linked to better baseline flexibility but less improvement. The findings suggest that while some increase in neural dynamics may help shift from rigid states, larger persisting increases may be less beneficial.
JAMA psychiatry
January 1, 2023
Brian D Kiluk, Bethea A Kleykamp, Sandra D Comer et al.
22 citations
A review sponsored by a public-private partnership addresses clinical trial design for new opioid use disorder (OUD) treatments that target systems other than the μ-opioid receptor. The authors present consensus recommendations for evaluating novel therapies such as cannabinoids, psychedelics, sedative-hypnotics, and immunotherapeutics. Key design elements include specifying the treatment stage (e.g., early abstinence, long-term recovery), defining the treatment's role (adjunctive or independent), selecting patient-informed primary outcomes that assess opioid use patterns, retention, and quality of life, and monitoring adverse events like relapse or overdose, especially when patients are not on maintenance opioid agonist or antagonist medications. Incorporating input from people with lived experience is urged to accelerate development and uptake of effective therapeutics.
The journal of pain
July 1, 2024
Patrick H Finan, Carly Hunt, Michael L Keaser et al.
18 citations
A pilot mechanistic randomized controlled trial tested a positive emotion-enhancing intervention called Savoring Meditation against a Slow Breathing control in 44 patients with rheumatoid arthritis. Savoring significantly reduced experimental pain intensity ratings relative to rest and increased cerebral blood flow in the ventromedial prefrontal cortex, as well as connectivity between that region and the caudate during painful stimulation. Participants in the Savoring condition also reported significantly increased positive emotions and reduced anhedonic symptoms from pre- to post-intervention. The findings suggest that Savoring recruits reward-enhancing corticostriatal circuits in the face of pain, warranting future work on clinical pain outcomes.
Mindfulness
April 1, 2023
Carly A Hunt, Janelle E Letzen, Samuel R Krimmel et al.
9 citations
A secondary analysis of a clinical trial compared a 12-week enhanced mindfulness-based stress reduction course (MBSR+) to stress management for headache in 98 migraine patients. Greater pre-treatment functional connectivity between the ventromedial prefrontal cortex and right nucleus accumbens predicted more meditation practice during MBSR+ and larger reductions in headache frequency. Participants who meditated more showed increased mindfulness and reduced helplessness related to pain, but not improvements in headache frequency, severity, or impact. Increased mindfulness mediated reductions in headache impact but not frequency. The findings suggest mesocorticolimbic system function relates to motivated behavior, and motivation-enhancing interventions might boost meditation engagement.